How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4,466.84 Median $7,244.36 Typical High $11,748.98 | Facility | None | $4,466.84 | $7,244.36 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $281.84 | Professional | None | $218.78 | $269.15 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,862.09 | $2,818.38 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $309.03 | Professional | None | $234.42 | $309.03 | $309.03 |
Horizon BCBS Setting Facility Modifier None Typical Low $2,951.21 Median $5,248.07 Typical High $14,125.38 | Facility | None | $2,951.21 | $5,248.07 | $14,125.38 |
Horizon BCBS Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $562.34 | Professional | None | $229.09 | $263.03 | $562.34 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,388.44 | $7,762.47 |
United Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $707.95 | Professional | None | $213.80 | $269.15 | $707.95 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $109.65 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $43.65 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $162.18 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $33.11 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.88 | $26.92 | $26.92 |
Where New Jersey sits
The same service costs 10.7 times more in Colorado than in Maine. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Jersey· 22nd of 51
$676
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.